Saturday, September 7, 2013
Fifteen Patients Possibly Exposed to Rare Brain Disease - Wall Street Journal
Hospitals in three states have cautioned 15 people that they were exposed to potentially contaminated surgical instruments used on an elderly New Hampshire person who died last month from a suspected rare and fatal brain disorder.
The odds other patients contracted Creutzfeldt-Jakob disease, or CJD, are considered very remote, health officials in Massachusetts, New Hampshire and Connecticut said. But because typical sterilization techniques aren't guaranteed to wipe out CJD, hospitals tracked down patients who had surgery with the same instruments used in May on the patient who later died.
Health authorities haven't disclosed specific details regarding that patient, but a spinal-fluid test lead them to suspect CJD, which causes memory loss, other cognitive problems and typically kills within a year, said Jose Montero, director of public health at the New Hampshire Department of Health and Human Services.
The disease can only be confirmed through autopsy results that are expected within four weeks, he said.
Catholic Medical Center in Manchester, N.H., reached out to eight patients who had brain surgery there with some of the suspect tools, though Dr. Montero called the chances of spreading the disease "extremely low." Five patients in Massachusetts were also notified because equipment used in the original New Hampshire surgery was eventually transferred to Cape Cod Hospital and used there, according to the Massachusetts Department of Public Health.
The Massachusetts cases are considered particularly low risk because those patients had spinal operations, and not brain surgery.
Dr. Montero confirmed there were also an unspecified number of New Hampshire spinal surgeries with suspect tools, but he said his state decided against notification because "we don't consider it a risk."
The Veterans Affairs hospital in West Haven, Conn., said Friday that it notified two patients about potential exposure. The Massachusetts and Connecticut cases were all linked to instruments made by Medtronic Inc.
The device maker said it quickly tracked the instruments after it was notified by Catholic Medical Center.
It is common for hospitals to borrow expensive systems like Medtronic's surgical imaging systems on a per-use basis, and the operating kits go with them. The other potential infections in New Hampshire don't involve Medtronic instruments.
According to the Centers for Disease Control and Prevention, CJD afflicts only about one of every million people each year. It most commonly occurs when normal cellular proteins known as prion proteins turn into abnormal, misfolded versions.
There are no known U.S. cases where the disease has spread through neurosurgery instruments, the CDC said. It has happened four times overseas, but not since 1976, the agency said.
It is likely that modern cleaning techniques like heat treatment lessen the risk, said Ermias Belay, acting director for the CDC's division of high-consequence pathogens and pathology.
But caution over potential exposure stems from lab experiments showing "how hard and difficult it is to deactivate the agent," he said.
If a patient did by chance contract the disease it could be decades before it takes hold. The incubation period can be as long as 50 years, the CDC said.
Write to Jon Kamp at jon.kamp@dowjones.com and Jennifer Levitz at jennifer.levitz@wsj.com
A version of this article appeared September 7, 2013, on page A5 in the U.S. edition of The Wall Street Journal, with the headline: Fifteen Patients Possibly Exposed To Brain Disease.
Source : http://online.wsj.com/article/SB10001424127887323893004579059421377098920.html
